S&C QCOR ASC 2567s
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ASCs 2567s
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Time Interval

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Provider Characteristics

Use these filters if you want to limit the report to providers that have certain characteristics. To select more than one option, hold down the Ctrl (individual point-and-click) OR Shift keys (select through a range) while you click on the additional desired option(s).

Survey Type & Deficiency Tags

Use these filters if you want to limit the reports to providers on specific survey types, or to reports that were cited for specific ASC deficiency tags and tag types. To select more than one option, hold down the Ctrl (individual point-and-click) OR Shift keys (select through a range) while you click on the additional desired option(s).

CCN and Facility Name

Use these filters if you know the name (or partial name) of the facility you are searching for, or the CMS Certification Number (CCN) for the facility you are searching for.

Other Survey Characteristics

Select one of the options below to filter by surveys that cite deficiencies or by surveys that are deficiency-free. By default, only surveys that cite deficiencies are displayed. Selecting "All" displays all surveys.

CMS Certification Number Facility Name Address City State CMS Region Date of CMS Survey Survey Event ID Survey Type Statement of Deficiencies Report
▼ 05C0001700 Procedure Center Of Irvine 16100 Sand Canyon Avenue Suite 170 Irvine CA 9 (San Francisco) 01/24/2018 2JTD21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
E0013 Development of EP Policies and Procedures Standard
E0029 Development of Communication Plan Standard
E0036 EP Training and Testing Standard
K0281 Illumination of Means of Egress Standard
K0291 Emergency Lighting Standard
K0341 Fire Alarm System - Installation Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0521 HVAC Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 05C0001702 Renaissance Surgery Center Of El Paseo 44139 Monterey Avenue Ste B Palm Desert CA 9 (San Francisco) 01/25/2019 KMD421 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
E0004 Develop EP Plan, Review and Update Annually Standard
E0013 Development of EP Policies and Procedures Standard
E0029 Development of Communication Plan Standard
E0036 EP Training and Testing Standard
K0291 Emergency Lighting Standard
K0293 Exit Signage Standard
K0342 Fire Alarm System - Initiation Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0372 Subdivision of Building Spaces ? Smoke Barrier Construction Standard
K0712 Fire Drills Standard
K0907 Gas and Vacuum Piped Systems ? Central Supply System Location Standard
K0908 Gas and Vacuum Piped Systems ? Central Supply System Alarms Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 05C0001702 Renaissance Surgery Center Of El Paseo 44139 Monterey Avenue Ste B Palm Desert CA 9 (San Francisco) 12/11/2018 KMD411 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0240 INFECTION CONTROL Condition
Q0064 STANDARD LEVEL TAG FOR SURGICAL SERVICES Standard
Q0162 FORM AND CONTENT OF RECORD Standard
Q0242 INFECTION CONTROL PROGRAM Standard
Q0261 PATIENT ASSESSMENT AND ADMISSION Standard
▼ 05C0001710 Canyon Pinole Surgery Center, Lp 1700 San Pablo Avenue, Suite D Pinole CA 9 (San Francisco) 03/28/2018 Y74G11 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0040 GOVERNING BODY AND MANAGEMENT Condition
Q0080 QUALITY ASSESSMENT AND PERFORMANCE Condition
Q0120 MEDICAL STAFF Condition
Q0140 NURSING SERVICES Condition
Q0219 PATIENT RIGHTS Condition
Q0240 INFECTION CONTROL Condition
Q0061 ANESTHETIC RISK AND EVALUATION Standard
Q0081 PROGRAM SCOPE; PROGRAM ACTIVITIES Standard
Q0082 PROGRAM DATA; PROGRAM ACTIVITIES Standard
Q0083 PERFORMANCE IMPROVEMENT PROJECTS Standard
Q0084 GOVERNING BODY RESPONSIBILITIES Standard
Q0101 PHYSICIAL ENVIRONMENT Standard
Q0105 EMERGENCY EQUIPMENT Standard
Q0121 MEMBERSHIP AND CLINICAL PRIVILEGES Standard
Q0122 REAPPRAISALS Standard
Q0141 ORGANIZATION AND STAFFING Standard
Q0162 FORM AND CONTENT OF RECORD Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0232 SAFETY Standard
Q0233 SAFETY - ABUSE/HARASSMENT Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0242 INFECTION CONTROL PROGRAM Standard
Q0243 INFECTION CONTROL PROGRAM - DIRECTION Standard
Q0261 ADMISSION ASSESSMENT Standard
Q0262 PRE-SURGICAL ASSESSMENT Standard
Q0264 POST-SURGICAL ASSESSMENT Standard
Q0265 DISCHARGE - SUPPLIES AND INFORMATION Standard
Q0266 DISCHARGE - ORDER Standard
▼ 05C0001712 Sutter Roseville Endoscopy Center 4 Medical Plaza Drive, Suite 210 Roseville CA 9 (San Francisco) 02/26/2020 OIKF21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
E0004 Develop EP Plan, Review and Update Annually Standard
E0006 Plan Based on All Hazards Risk Assessment Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0355 Portable Fire Extinguishers Standard
▼ 05C0001712 Sutter Roseville Endoscopy Center 4 Medical Plaza Drive, Suite 210 Roseville CA 9 (San Francisco) 02/07/2020 OIKF11 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0061 ANESTHETIC RISK AND EVALUATION Standard
Q0082 PROGRAM DATA; PROGRAM ACTIVITIES Standard
Q0101 PHYSICAL ENVIRONMENT Standard
Q0109 EMERGENCY EQUIPMENT Standard
Q0122 REAPPRAISALS Standard
Q0162 FORM AND CONTENT OF RECORD Standard
Q0221 NOTICE OF RIGHTS Standard
Q0223 NOTICE - PHYSICIAN OWNERSHIP Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0242 INFECTION CONTROL PROGRAM Standard
Q0261 PATIENT ASSESSMENT AND ADMISSION Standard
Q0262 ADMISSION AND PRE-SURGICAL ASSESSMENT Standard
▼ 05C0001715 Fullerton Surgical Center 2240 Harbor Blvd, Suite 100 Fullerton CA 9 (San Francisco) 09/15/2025 1D6D37-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0242 INFECTION CONTROL PROGRAM Standard
▼ 05C0001715 Fullerton Surgical Center 2240 Harbor Blvd, Suite 100 Fullerton CA 9 (San Francisco) 09/12/2023 60F64-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0064 STANDARD LEVEL TAG FOR SURGICAL SERVICES Standard
Q0101 PHYSICAL ENVIRONMENT Standard
Q0241 SANITARY ENVIRONMENT Standard
▼ 05C0001715 Fullerton Surgical Center 2240 Harbor Blvd, Suite 100 Fullerton CA 9 (San Francisco) 02/05/2020 3NEJ21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
E0009 Local, State, Tribal Collaboration Process Standard
E0022 Policies/Procedures for Sheltering in Place Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0026 Roles Under a Waiver Declared by Secretary Standard
E0030 Names and Contact Information Standard
E0031 Emergency Officials Contact Information Standard
E0039 EP Testing Requirements Standard
K0161 Building Construction Type and Height Standard
K0291 Emergency Lighting Standard
K0293 Exit Signage Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0511 Utilities - Gas and Electric Standard
K0521 HVAC Standard
K0911 Electrical Systems - Other Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
K0920 Electrical Equipment ? Power Cords and Extension Cords Standard
▼ 05C0001715 Fullerton Surgical Center 2240 Harbor Blvd, Suite 100 Fullerton CA 9 (San Francisco) 01/23/2020 3NEJ11 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0062 ANESTHETIC - DISCHARGE Standard
Q0101 PHYSICAL ENVIRONMENT Standard
Q0141 ORGANIZATION AND STAFFING Standard
Q0162 FORM AND CONTENT OF RECORD Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0202 RADIOLOGIC SERVICES Standard
Q0222 NOTICE OF RIGHTS - POSTING Standard
Q0229 EXERCISE OF RIGHTS - INFORMED CONSENT Standard
Q0234 CONFIDENTIALITY OF CLINICAL RECORDS Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0242 INFECTION CONTROL PROGRAM Standard
Q0262 ADMISSION AND PRE-SURGICAL ASSESSMENT Standard